KESMA FLAME LILY LLC NPI 1295212355

NPI Information

NPI: 1295212355
Provider Name: KESMA FLAME LILY LLC
Classification: Counselor - 101YP2500X
Entity Type: Organization

Specialization: Professional

Address:
2800 FREEWAY BLVD
STE 204/7
MINNEAPOLIS, MN
ZIP 55430
Phone: (612) 408-7733
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KESMA FLAME LILY LLC is a professional counselor in Minneapolis, MN. KESMA FLAME LILY LLC NPI is 1295212355. The provider is registered as an organization entity type.

The provider's business location address is:

2800 FREEWAY BLVD
STE 204/7
MINNEAPOLIS, MN
ZIP 55430-543
Phone: (612) 408-7733
Fax: (763) 292-5653

The provider's authorized official is Petronellah Thoko Thomas-shanobi .
The authorized official title is Ceo/clinical Director and has the following contact phone number (612) 408-7733.

The enumeration date for this NPI number is 7/22/2018 and was last updated on 9/25/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	Primary
1	251E00000X	Home Health		No
2	101YM0800X	Counselor	Mental Health	No
3	261QC1500X	Clinic/Center	Community Health	No
4	261QM0801X	Clinic/Center	Mental Health (Including Community Mental Health Center)	No
5	251S00000X	Community/Behavioral Health		No
6	261QM1000X	Clinic/Center	Migrant Health	No
7	252Y00000X	Early Intervention Provider Agency		No
8	101YP2500X	Counselor	Professional	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0000000	OTHER	MINNESOTA	BEHAVIORAL HEALTH
2	6744924000	MEDICAID	MINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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